Background Health professional organizations use lobbying to influence legislation that impacts patient care and their respective fields. Physician professional organizations (PPOs) are societies and associations that promote profession advancement through avenues such as research, practice guidelines, and continued medical education. PPOs spend lobbying dollars to advocate for specific interests, which vary by specialty, but research is lacking regarding lobbying patterns across PPOs. We sought to identify and quantify trends in lobbying spending with a focus on medical versus surgical PPOs.

Methods We extracted publicly available lobbying data from OpenSecrets (https://www.opensecrets.org) focusing on PPOs. We excluded coalitions, commercial groups, private practices, and all non-physician organizations. PPOs were further categorized as medical, surgical, or overlapping. We determined annual lobbying spending from 2014-2023 for each category and adjusted dollar values to 2023 USD using the Consumer Price Index inflation calculator. We used physician data from the American Association of Medical Colleges (AAMC) to calculate lobbying spending on a per-physician basis. A Mann-Kendall test was used to describe temporal trends in lobbying.

Results Over the study period, median spending by health professionals was $108 million/year, with PPOs contributing $71 million/year (65%). Overall, lobbying spending by health professionals trended downward but not significantly (p=0.06). In contrast, we found a significant downward trend in lobbying spending by PPOs over time (p<0.01). Within PPOs, lobbying spending was $32 million/year (45%) by medical specialty organizations and $12 million/year (16%) by surgical specialty organizations (10-year median values). PPOs in the overlapping category made up $27 million/year (39%) (median). Medical specialty organizations showed a significant downward trend over time in spending (p=0.04), while lobbying by surgical specialty organizations did not significantly change (p=0.09). PPO lobbying spending on a per-physician basis was $78/year for all physicians, $48/year for medical specialists, and $81/year for surgeons (median values). There were 521 lobbyists/year representing PPOs, with 352 (68%) representing medical specialties, 93 (18%) representing surgical specialties, and 79 (15%) in the overlapping category.

Conclusion In this study, we found that overall lobbying by health professional groups has remained stable. However, spending by PPOs and specifically those representing medical specialties have significantly decreased over time. Notably, although surgical specialty organizations made up a smaller percentage of total lobbying, their spending on a per-physician basis was generally higher. These findings assist in better understanding the complex intersection of lobbying and physician advocacy, while informing future efforts to evaluate priority issues for physician organizations.